Project Summary The long term goal of this project is to find features that better predict breast cancer in African American women and may point to early events of breast cancer. Breast cancer is the most frequently diagnosed and second leading cause of cancer deaths in women in the United States, and African American women are especially burdened with higher breast cancer mortality than women of other ethnic groups. This etiology of this survival disparity is not completely understood and multifactorial. As African American women are more likely to be diagnosed at later stage disease than women of other ethnicities, African American women may benefit from improved cancer risk prediction to detect disease earlier. However, progress to improve risk prediction in this population are slowed by the few number of cohorts studying African American women and breast cancer. Clinical assessments of breast tissue using mammography and breast biopsy are critical to understanding breast cancer risk. Dense breast tissue on mammogram and benign breast disease (BBD) on biopsy are associated with increased risk of developing breast cancer in European American cohorts. The sponsor?s laboratory has established a cohort of women diagnosed with BBD in Detroit to study subsequent risk of breast cancer. We propose two aims to better characterize novel tissue-based breast cancer risk factors in this underserved population. For the first aim, we will determine breast density and other radiologic features on mammogram at the time of breast biopsy in a nested case/control study within our Detroit cohort of African American women diagnosed with BBD to estimate breast cancer risk associated with these features. We will then characterize obesity-related inflammation using immunohistochemistry in normal, BBD-adjacent and malignancy-adjacent breast tissue from the Komen Normal Tissue Bank and a subset of the Detroit cohort to assess the relevance of this pathologic feature as a risk factor. The interdisciplinary training environment, highly committed and experienced mentors, and research plan will provide the applicant ample opportunity to develop into a future independent researcher as a physician scientist addressing cancer disparities.